Blood cancer cases are rising alarmingly among young Indians, with leukemia incidences increasing and bone marrow transplants on the rise. In this exclusive interview, Dr Suruchi Aggarwal, Head – Scientific Affairs, MedGenome sheds light on the causes, challenges, and cutting-edge treatments for blood cancer in India.
Q: As an expert in oncogenomics, can you share insights on the rising incidence of blood cancer, especially among young Indians?
A: India lacks concrete numbers, but leukemia incidences are increasing, and bone marrow transplants are rising alarmingly. Age is a significant factor, with leukemias typically developing after 40. However, young individuals are increasingly affected. This trend is concerning, and we need to investigate the underlying causes. Pollution, lifestyle changes, and genetic predispositions are potential factors contributing to this rise.
Q: What are the major risk factors for blood cancer?
A: Pollution, specifically air pollution, vehicle exhausts, and factory outputs containing benzene or P2M 0.5 gases, increase the risk. Lifestyle factors like diet and nutrition play a role, and genetic predispositions, such as Leigh Frumani syndrome or TP53 mutation, can also contribute. Additionally, exposure to toxic substances, radiation, and certain chemicals can increase the risk. Understanding these risk factors can help us develop targeted prevention strategies.
Q: How effective are NGS-based tests in detecting blood cancer?
A: Next-generation sequencing (NGS) is a game-changer, enabling multiple gene testing in a single test. NGS detects genomic biomarkers defining different blood cancer types, aiding treatment and disease prognostication. This technology has revolutionized cancer diagnosis, allowing for personalized medicine approaches. By identifying specific genetic mutations, we can tailor treatment to individual patients, improving outcomes.
Q: What challenges persist in terms of accessibility, affordability, and quality of care?
A: Accessibility is limited to tertiary care centers, mainly in urban areas. Affordability is a concern due to high treatment costs. Quality varies among centers, making it difficult for patients to choose. Furthermore, awareness about blood cancer and its symptoms is low, leading to delayed diagnosis. Addressing these challenges requires a multi-faceted approach, including increasing accessibility, reducing costs, and improving healthcare infrastructure.
Q: What lifestyle modifications can young people take to prevent blood cancer?
A: Avoiding air pollution, using masks, staying indoors, and maintaining a healthy lifestyle, including a balanced diet and avoiding tobacco, can help. Understanding familial risk and genetic predisposition is also crucial. Regular exercise, stress management, and adequate sleep can also contribute to overall health. Additionally, avoiding exposure to toxic substances and radiation can reduce risk.
Q: What research initiatives have been taken to tackle blood cancer in India?
A: Organizations like ICMR have programs for early screening, and CAR-T therapy has been developed in India for ALL patients. Research focuses on understanding genetic predispositions, identifying novel biomarkers, and developing targeted therapies. Collaborations between academia, industry, and healthcare providers are essential for advancing blood cancer research.
Q: How can technology and genomics improve treatment outcomes?
A: Genomics, AI, liquid biopsy, and MRD detection techniques can enhance treatment. Creating Indian-specific databases will aid in leveraging leukemia treatment. Precision medicine approaches, tailored to individual genetic profiles, can improve treatment efficacy. Furthermore, telemedicine and digital health platforms can increase accessibility and improve patient engagement.
Q: Can you elaborate on the differences in blood cancer prevalence among different age groups and regions in India?
A: Acute lymphoid leukemias prevail in younger age groups, while acute myeloid leukemia and plasma cytoma are more common in older groups. Regional differences exist, with South India showing myeloproliferated neoplasms, North East showing lymphomas, and Northern states showing acute lymphoblastic leukemia. These variations may be attributed to genetic, environmental, or lifestyle factors.
Q: Can you share a case study where early detection helped in effective treatment?
A: A young male with acute myeloid leukemia achieved complete remission after genetic testing revealed a rare translocation, guiding targeted combination therapy. This case highlights the importance of genetic testing in identifying actionable biomarkers. Early detection and personalized treatment approaches can significantly improve outcomes.
Q: Are there statistics on blood cancer incidents among young Indians?
A: According to ICMR’s National Cancer Registry Program, approximately 8-10% of leukemia cases in young adults are ALL and AML, with ALL being the most predominant type. Delhi and Mumbai report the highest incidence rates. Understanding these statistics can inform prevention and early detection strategies.
A: Targeted therapy based on specific genomic biomarkers yields good responses. For example, CML patients with BCR-ABL fusion respond well to tyrosine kinase inhibitors. Early detection and treatment can improve survival rates and quality of life. However, relapse remains a concern, emphasizing the need for ongoing monitoring and adjustment of treatment strategies.
Q: How aggressive is treatment in the case of relapse?
A: Treatment is adjusted based on disease stage, genomic profile, and patient factors. Benefit of therapy outweighs the side effects.